Clinical efficacy of super-mini-percutaneous nephroscope combined with flexible ureteroscopic lithotripsy in oblique supine lithotomy position in the treatment of 2.0-3.0 cm renal calculi / 现代泌尿外科杂志

【Objective】 To compare the clinical safety and effectiveness of super-mini-percutaneous nephroscope (SMP) combined with flexible ureteroscopic lithotripsy (FURL) in oblique supine lithotomy position and FURL alone in the treatment of 2.0-3.0 cm renal calculi. 【Methods】 Clinical data of 55 patients treated during Jan.2018 and May 2021 were retrospectively analyzed, including 47 cases complicated renal calculi, and 14 cases of lower calyceal calculi with infundibulopelvic angle ≤30°. SMP combined with FURL was performed in 23 cases (combined group), and FURL alone was performed in 32 cases (FURL group). The operation time, hemoglobin reduction, postoperative hospital stay, hospitalization expenses, stone-clearance rate and complications were compared. 【Results】 All operations were successful. Compared with the FRUL group, the combined group had significantly more hemoglobin reduction [(16.30±10.17) g/L vs. (6.94±6.61) g/L], longer postoperative hospital stay [(5.35±1.61) d vs. (3.19±1.26) d], and higher hospitalization expenses [(22 481±2 234) yuan vs. (18 209±2 584) yuan] (P0.05]. One month after surgery, CT results showed that the combined group had higher stone-clearance rate (91.30% vs. 65.63%, P=0.027). There was no difference in the complication rate (21.74% vs. 21.88%, P>0.05). One case (4.35%) in the combined group and 5 cases (15.63%) in the FURL group received retreatment (P>0.05). 【Conclusion】 SMP combined with FURL in oblique supine lithotomy position is safe and effective in the treatment of 2.0-3.0 cm renal calculi, with high stone-clearance rate and low complication rate.

A review on cardiovascular disease risk prediction models in the elderly / 中华流行病学杂志

Risk prediction models play an important role in the primary prevention of cardiovascular diseases (CVD) in the elderly population. There are fifteen papers about CVD risk prediction models developed for the elderly domestically and internationally, of which the definitions of disease outcome vary widely. Ten models were reported with insufficient information about study methods or results. Ten models were at high risk of bias. Thirteen models presented moderate discrimination in internal validation, and only four models have undertaken external validation. The CVD risk prediction models for the elderly differed from those for the general population in terms of model algorithm and the effect size of association between predictor and outcome, and the prediction performance of the models for the elderly attenuated. In the future, high-quality external validation researches are necessary to provide more solid evidence. Different ways, including adding new predictors, using competing risk model algorithms, machine learning methods, or joint models, and altering the prediction time horizon, should be explored to optimize the current models.

Effects of total ginsenosides from Panax ginseng stems and leaves on gut microbiota and short-chain fatty acids metabolism in acute lung injury mice / 中国中药杂志

This study aimed to investigate the biological effects and underlying mechanisms of the total ginsenosides from Panax ginseng stems and leaves on lipopolysaccharide(LPS)-induced acute lung injury(ALI) in mice. Sixty male C57BL/6J mice were randomly divided into a control group, a model group, the total ginsenosides from P. ginseng stems and leaves normal administration group(61.65 mg·kg~(-1)), and low-, medium-, and high-dose total ginsenosides from P. ginseng stems and leaves groups(15.412 5, 30.825, and 61.65 mg·kg~(-1)). Mice were administered for seven continuous days before modeling. Twenty-four hours after modeling, mice were sacrificed to obtain lung tissues and calculate lung wet/dry ratio. The number of inflammatory cells in bronchoalveolar lavage fluid(BALF) was detected. The levels of interleukin-1β(IL-1β), interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α) in BALF were detected. The mRNA expression levels of IL-1β, IL-6, and TNF-α, and the levels of myeloperoxidase(MPO), glutathione peroxidase(GSH-Px), superoxide dismutase(SOD), and malondialdehyde(MDA) in lung tissues were determined. Hematoxylin-eosin(HE) staining was used to observe the pathological changes in lung tissues. The gut microbiota was detected by 16S rRNA sequencing, and gas chromatography-mass spectrometry(GC-MS) was applied to detect the content of short-chain fatty acids(SCFAs) in se-rum. The results showed that the total ginsenosides from P. ginseng stems and leaves could reduce lung index, lung wet/dry ratio, and lung damage in LPS-induced ALI mice, decrease the number of inflammatory cells and levels of inflammatory factors in BALF, inhibit the mRNA expression levels of inflammatory factors and levels of MPO and MDA in lung tissues, and potentiate the activity of GSH-Px and SOD in lung tissues. Furthermore, they could also reverse the gut microbiota disorder, restore the diversity of gut microbiota, increase the relative abundance of Lachnospiraceae and Muribaculaceae, decrease the relative abundance of Prevotellaceae, and enhance the content of SCFAs(acetic acid, propionic acid, and butyric acid) in serum. This study suggested that the total ginsenosides from P. ginseng stems and leaves could improve lung edema, inflammatory response, and oxidative stress in ALI mice by regulating gut microbiota and SCFAs metabolism.

Observation of the growth and development of subchondral bone in rat condyles exposed to fluoride at the level of bone microarchitecture / 中华地方病学杂志

Objective:To observe the effect of fluoride on growth and development of bone microstructure of rats condyle subchondral bone (RCSB).Methods:Forty two 3-week-old SD rats (half male and half female) were fed adaptively for 1 week, and 3 females and 3 males were sacrificed and recorded as 0 month. The remaining rats were randomly divided into control group ( n = 18) and fluoride exposed group ( n = 18) according to their body weight (55 - 70 g), half male and half female. The fluoride exposed group was fed with 150 mg/L sodium fluoride (NaF) aqueous solution, and the control group was fed with tap water. The two groups of experimental animals were sacrificed at 3, 5 and 7 month, respectively, 6 rats in each group, half male and half female. The right mandibular condyle was separated, and Micro CT scanning was performed to detect the microstructure parameters of RCSB. Results:In fluoride exposed group (3 month), bone surface/tissue volume (BS/TV), bone surface/bone volume (BS/BV), trabecular thickness (Tb.Th), trabecular number (Tb.N), structure model index (SMI), connectivity, connectivity density (Conn.D) and total porosity of female rats were significantly different from those of male rats ( t = - 5.10, - 5.58, 4.52, - 4.32, - 4.03, - 2.81, - 6.71, - 3.32, P < 0.05). There was no significant difference in each index between female and male rats in fluoride exposed group (5, 7 month, P > 0.05). Conclusion:In chronic fluorine exposure bone environment, the RCSB bone microarchitecture of male and female rats is different with time, showing the tendency of fluoride injury that the bone changes of female rats are slowed and the bone changes of male rats are active.

Comparative study on fluoride accumulation in hard tissues of rats with chronic drinking-water-borne fluorosis / 环境与职业医学

Background A large number of studies on fluoride-induced systemic bone damage have been reported previously, but there is little understanding of the characteristics of fluoride accumulation in jawbone. Jawbone is homologous to the other bone tissues in the body, and is an indispensable and important frame structure in the oral cavity. Objective To study fluoride accumulation and its change trends in teeth, jawbone, and femur of SD rats with chronic drinking-water-borne fluorosis. Methods A total of 144 three-week-old SD rats, half male and half female, were randomly divided into two groups, a normal control group and a fluoride group. The rats in the normal controlgroup drank purified water disinfected and filtered from Guizhou, and the water contained 0.08 mg·kg−1 fluoride which was lower than the national water quality standard at 1 mg·kg−1. The rats in the fluoride group were fed with sodium fluoride (NaF) solution with a concentration of 150 mg·L−1. At 3, 5 and 7 months of the fluoride exposure, the levels of fluoride in urine, blood, teeth, jawbone, and femur were measured by fluoride ion electrode method. Results There was no sex difference in fluoride content in different biological samples of rats in the fluoride group and the normal control group (all P>0.05). After 3 months of fluoride exposure, the rats in the fluoride group showed dental fluorosis of grade II, and higher levels of fluoride ion in blood and urine than the normal control group (all P<0.05), indicating that the rat model of fluoride drinking-water-borne chronic fluorosis was successfully replicated. In the normal control group, the levels of fluoride in femur remained stable; at the end of 3 months, the levels of fluoride in jawbone and teeth were (1097.36±470.34) and (453.09±173.43) mg·kg−1 respectively, and at the end of 7 months, the levels of fluoride in jawbone and teeth were (2113.18±634.49) and (1604.80±160.43) mg·kg−1 respectively. Both jawbone and teeth showed a positive temporal effect of increasing fluoride accumulation (P<0.05). After continuous fluoride feeding, the fluoride levels in jawbone, teeth, and femur of rats in the fluoride group were (3145.02±765.82), (1550.20±77.73), and (3640.55±699.42) mg·kg−1 after 3 months, and (8420.36±1728.56), (4702.08±1417.06), and (6091.99±1384.97) mg·kg−1 after 7 months. The three kinds of hard tissues all showed a positive temporal effect of increasing fluoride accumulation (P<0.05), and the cumulative increas was large than that in the normal control group. Among them, jawbone fluorine increased most. At the end of 5 months, the levels of fluoride in jawbone, femur, and teeth were (6485.02±2141.98), (4914.99±1529.41), and (3365.21±1462.27) mg·kg−1 respectively, and the levels of fluoride in jawbone was much higher than those in femur and teeth (P<0.05). Conclusion Hard tissues such as bones and teeth are fluorine sensitive tissues. Compared with femur, jawbone showed significantly high fluoride accumulation, while teeth show relatively lagging fluoride accumulation.

Prevention and treatment of complications in the treatment of femoral shaft closed fracture with core drilling intramedullary nail / 中国骨伤

OBJECTIVE@#To summarize the complications of core drilling intramedullary nail in the treatment of femoral shaft closed fracture and explore the treatment strategy.@*METHODS@#From August 2014 to June 2018, a total of 215 patients with closed femoral shaft fractures were treated with closed reduction core drill intramedullary nail, including 129 males and 86 females, aged from 18 to 62 years, with an average of (44.2±10.6) years old. The time from injury to operation was 3 to 21 days. There were 102 cases of AO type A fracture, 82 cases of AO type B fracture and 31 cases of AO type C fracture. The time of operation, the amount of blood loss during operation, the duration of hospitalization, the time of fracture healing and the HSS score of knee joint function at the last follow-up were recorded. The observation of complications included:iatrogenic fracture, core drill broken, core drill twist, postoperative infection, and fracture nonunion.@*RESULTS@#The average operation time was (63.2± 15.6) min and intraoperative blood loss was (150.0±34.5) ml. All the incisions reached grade A healing. Patients were follow up for a mean of (18.5±3.2) months, the average hospital stay was (4.3±1.2) days, and the average fracture healing time was (5.6±2.3) months. At the final follow-up, the average HSS score of knee joint was 90.3±4.7. Related complications occurred in 37 cases (17.2%). The core drill related complications occurred in 13 cases (6.0%), including core drill broken in 5 cases (2.3%), core removal in 1 case and slotting in 4 cases;core drill twist in 8 cases (3.7%). After the core was cut, the core was removed. Similar complicationsof conventional intramedullary nail:iatrogenic fracture was performed in 12 cases (5.6%), including 10 cases of fracture end split and 2 cases of distal perimedullary fracture of intramedullary nail. The patients with cleavage at the fracture end were not treated after judging their stability, and the patients with fracture around the distal end of the intramedullary nail were fixed with auxiliary steel plate during operation;1 case(0.4%) with delayed infection after operation, debridement and external fixation was replaced and healed after bone transfer; fracture nonunion occurred in 11 cases (5.1%), of which 7 cases (3.3%) were hypertrophic nonunion and healed with additional plate. Atrophic nonunion occurred in 4 cases (1.9%), which healed after additional steel plate and bone graft.@*CONCLUSION@#Core drilling intramedullary nail is an effective method for the treatment of closed femoral shaft fracture, and the complications include core drill related complications and conventional intramedullary nail similar complications. Accurate preoperative evaluation, careful operation during operation and early postoperative symptomatic treatment can effectively reduce the occurrence of related complications.

Death and do-not-resuscitate order in the emergency department: A single-center three-year retrospective study in the Chinese mainland / 世界急诊医学杂志（英文）

@# Current Issue Archive 15 December 2020, Volume 11 Issue 4 Previous Issue Improving antibiotic prescribing in the emergency department for uncomplicated community-acquired pneumonia Rebekah Shaw, Erica Popovsky, Alyssa Abo, Marni Jacobs, Nicole Herrera, James Chamberlain, Andrea Hahn World Journal of Emergency Medicine. 2020, 11(4): 199-205. doi:10.5847/wjem.j.1920-8642.2020.04.001 Asbtract HTML PDF (151KB) Outcome prediction value of National Early Warning Score in septic patients with community-acquired pneumonia in emergency department: A single-center retrospective cohort study Hai-jiang Zhou, Tian-fei Lan, Shu-bin Guo World Journal of Emergency Medicine. 2020, 11(4): 206-215. doi:10.5847/wjem.j.1920-8642.2020.04.002 Asbtract HTML PDF (255KB) Effects of fluid balance on prognosis of acute respiratory distress syndrome patients secondary to sepsis Yu-ming Wang, Yan-jun Zheng, Ying Chen, Yun-chuan Huang, Wei-wei Chen, Ran Ji, Li-li Xu, Zhi-tao Yang, Hui-qiu Sheng, Hong-ping Qu, En-qiang Mao, Er-zhen Chen World Journal of Emergency Medicine. 2020, 11(4): 216-222. doi:10.5847/wjem.j.1920-8642.2020.04.003 Asbtract HTML PDF (107KB) Effects of sepsis on hippocampal volume and memory function Miao Yuan, Ding-yi Yan, Fang-shi Xu, Yi-di Zhao, Yang Zhou, Long-fei Pan World Journal of Emergency Medicine. 2020, 11(4): 223-230. doi:10.5847/wjem.j.1920-8642.2020.04.004 Asbtract HTML PDF (138KB) Death and do-not-resuscitate order in the emergency department: A single-center three-year retrospective study in the Chinese mainland Chuan-qi Ding, Yu-ping Zhang, Yu-wei Wang, Min-fei Yang, Sa Wang, Nian-qi Cui, Jing-fen Jin World Journal of Emergency Medicine. 2020, 11(4): 231-237. doi:10.5847/wjem.j.1920-8642.2020.04.005 Asbtract HTML PDF (144KB) BACKGROUND: Consenting to do-not-resuscitate (DNR) orders is an important and complex medical decision-making process in the treatment of patients at the end-of-life in emergency departments (EDs). The DNR decision in EDs has not been extensively studied, especially in the Chinese mainland. METHODS: This retrospective chart study of all deceased patients in the ED of a university hospital was conducted from January 2017 to December 2019. The patients with out-of-hospital cardiac arrest were excluded. RESULTS: There were 214 patients’ deaths in the ED in the three years. Among them, 132 patients were included in this study, whereas 82 with out-of-hospital cardiac arrest were excluded. There were 99 (75.0%) patients’ deaths after a DNR order medical decision, 64 (64.6%) patients signed the orders within 24 hours of the ED admission, 68 (68.7%) patients died within 24 hours after signing it, and 97 (98.0%) patients had DNR signed by the family surrogates. Multivariate analysis showed that four independent factors influenced the family surrogates’ decisions to sign the DNR orders: lack of referral (odds ratio [OR] 0.157, 95% confidence interval [CI] 0.047-0.529, P=0.003), ED length of stay (ED LOS) ≥72 hours (OR 5.889, 95% CI 1.290-26.885, P=0.022), acute myocardial infarction (AMI) (OR 0.017, 95% CI 0.001-0.279, P=0.004), and tracheal intubation (OR 0.028, 95% CI 0.007-0.120, P<0.001). CONCLUSIONS: In the Chinese mainland, the proportion of patients consenting for DNR order is lower than that of developed countries. The decision to sign DNR orders is mainly affected by referral, ED LOS, AMI, and trachea intubation.

Treatment of intertrochanteric fracture of femur with closed reduction of proximal femoral anti rotation intramedullary nail in supine position / 中国骨伤

OBJECTIVE@#To investigate the effect and feasibility of closed reduction and internal fixation with PFNA in the treatment of intertrochanteric fracture of femur in the supine position without traction bed.@*METHODS@#From June 2014 to March 2018, 45 patients with intertrochanteric fracture of femur who were treated and followed up were analyzed retrospectively. There were 21 males and 24 females, with an average age of 67.4 years (43 to 92 years);18 cases on the left side and 27 on the right side. According to Evans Jensen classification, there were 7 patients of type Ⅱ, 17 patients of type Ⅲ, 16 patients of type Ⅳ and 5 patients of type Ⅴ. The time from injury to operationwas 2 to 6 days. The operation time, blood loss and fracture healing, closing time, postoperative complications and Harris score of hip joint were recorded.@*RESULTS@#The operation time of 45 patients was 35 to 80 min, with an average of 52.6 min;the intraoperative bleeding volume was 40 to 110 ml, with an average of 68.7 ml;the hospitalization time was 6 to 11 days, with an average of 8.4 days;the follow up time was 12 to 18 months, with an average of 14.7 months;the internal fixation of 2 patients failed, and 43 patients achieved bony healing;the deep vein thrombosis of the lower extremity in the perioperative period was 1 case, and the inferior vena cava filter was inserted;the internal fixation of 2 patients was cut out, and the hip was renovated. The incidence of complications was 8.9%(4 / 45). At the final follow up, Harris score of hip joint was 56 to 95 (81.30±8.40), including excellent 15 cases, good 26 cases, fair 2 cases and poor 2 cases.@*CONCLUSION@#It is safe and feasible to treat intertrochanteric fracture of femur with closed reduction and anti rotation intramedullary nailing under the bed without traction in a supine position. It has the advantages of small trauma and low complications, and the clinical effect is satisfactory. It is worth popularizing and using in basic hospitals.

Effect of Ru′ai Shuhou Prescription on Proliferation and Metastasis of Breast Cancer MDA-MB-453 Cells Through SDF-1/CXCR4 Biological Axis / 中国实验方剂学杂志

Objective:To investigate the effect of Ru′ai Shuhou prescription （RSR） drug-containing serum on the proliferation and invasion ability of breast cancer cells MDA-MB-453 based on the biological axis of stromal cell-derived factor-1（SDF-1）/chemokine receptor 4 （CXCR4）. Method:A model of MDA-MB-453 cells with SDF-1-induced high expression of CXCR4 was established， and the rat drug-serum containing RSR and blank rat serum were prepared respectively. The cells were divided into fetal bovine serum control group （Blank）， blank rat serum group， SDF-1+blank rat serum group， SDF-1+RSR group， AMD3100+ SDF-1+blank rat serum group， and AMD3100+ SDF-1+RSR group. After intervention for 48 h， cell proliferation was detected by cell counting kit-8 （CCK-8） assay， cell invasion ability was detected by transwell assay， and mRNA and protein expressions of CXCR4， matrix metalloproteinase-2 （MMP-2） and MMP-9 were detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot， respectively. Result:As compared with the blank serum group， the proliferation of MDA-MB-453 cells was promoted and expression of CXCR4 mRNA was increased significantly when SDF-1 was 100 μg·L-1 （P<0.05）. As compared with SDF-1+blank rat serum group， RSR inhibited the proliferation and invasion of MDA-MB-453 cells induced by SDF-1， and at the same time， down-regulated the mRNA and protein expressions of CXCR4， MMP-2 and MMP-9 （P<0.05）. After pre-treatment with AMD3100 for 24 h， the inhibitory effect of RSR to cell proliferation was significantly increased （P<0.05）， and meanwhile， the decreases in mRNA and protein expression of CXCR4， MMP-2 and MMP-9 were more obvious， with statistically significant differences （P<0.05）. Conclusion:Through SDF-1/CXCR4 biological axis， RSR could down-regulate the expression of MMP-2 and MMP-9， reduce the degradation of extracellular matrix （ECM）， and then inhibit the metastasis of MDA-MB-453 cells. In addition， it has a synergistic effect with CXCR4 inhibitor AMD3100.

The relationship between uric acid urolithiasis and dyslipidemia / 中华泌尿外科杂志

Objective:To evaluate the relationship between dyslipidemia and uric acid urolithiasis, and explore the risk factors of uric acid urolithiasis.Methods:93 patients with uric acid urolithiasis identified by stone composition analysis were retrospective analyzed from January 2014 to October 2019 were classified as uric acid urolithiasis group.Among them there were 77 men accounting for 82.8%, 16 women accounting for 17.2%, the median age is 64 years old.According to sex, age and other conditions, 321 patients with calcium oxalate urolithiasis in the same period were selected as calcium oxalate stone group. Among them there were 264 men accounting for 82.2%, 57 women accounting for 17.8%, the average age is 64 years old.While 306 non-stone people examined in hospital as control group in the same period who matched with age and gender. Among them there were 252 men accounting for 82.4%, 54 women accounting for 17.6%, the average age is 61 years old. There was no significant difference in age and sex ratio among the three groups. The body mass index (BMI) of uric acid urolithiasis group, calcium oxalate urolithiasis group and control group were significantly different( P<0.01). Serum uric acid, urine pH and blood lipids: triglyceride (TG), cholesterol (TC), high density lipoprotein (HDL-C) and low density lipoprotein (LDL-C) were recorded in the three groups, and the correlation between the above indexes and stone composition was analyzed.The uric acid urolithiasis group was divided into hyperuricemia(HUA) group (n=41) and Non HUA group (n=52) according to serum uric acid, and 66 cases with HUA were selected in the control group. The dyslipidemia and urine pH levels of the above three groups were compared. The multivariate Logistic regression analysis was used to identify the independent risk factors associated with uric acid urolithiasis formation. Results:There were significant differences in TG level, incidence of hypertrigly-ceridemia, low HDL-cholesterolemia, high LDL-cholesterolemia, serum uric acid and urine pH between uric acid urolithiasis group and calcium oxalate urolithiasis group( P<0.05). Significant differences were seen in TG level, HDL-C level, incidence of hypertriglyceridemia and low HDL-cholesterolemia, serum uric acid and urine pH between uric acid urolithiasis group and control group.There was significant difference in urine pH between uric acid urolithiasis with and Non HUA group. Significant difference in the incidence of hypertriglyceridemia and low HDL-cholesterolemia were seen between uric acid urolithiasis with HUA group and HUA group.Multivariate Logistic regression analysis showed that obesity(odds ratio=1.68, P<0.001), hypertriglyceridemia(odds ratio=7.37, P=0.002), low HDL-cholesterolemia(odds ratio=10.46, P=0.001) and low urinary pH(odds ratio=0.10, P<0.001) were independent risk factors for uric acid urolithiasis. Conclusions:Dyslipidemia was more likely associated with uric acid urolithiasis. Obesity, hypertriglyceridemia, low HDL-cholesterolemia and low urinary pH are closely related to the occurrence of uric acid urolithiasis.

Light and heat of moxibustion for knee osteoarthritis：a multi-center randomized controlled trial / 中国针灸

OBJECTIVE@#To explore the clinical therapeutic effect of light and heat of moxibustion for knee osteoarthritis (KOA).@*METHODS@#A total of 216 patients with KOA were randomized into a traditional moxibustion group (72 cases, 8 cases dropped off), a moxibustion light group (72 cases, 9 cases dropped off) and a moxibustion heat group (72 cases, 10 cases dropped off).The special light-heat separation moxibustion cup was applied, the patients in the traditional moxibustion group received the treatment of moxibustion, the patients in the moxibustion light group received the treatment of moxibustion light and the patients in the moxibustion heat group received the treatment of moxibustion heat. The acupoint selection of the three groups was Neixiyan (EX-LE 4), Dubi (ST 35) and Zusanli (ST 36), the treatment was given 20 min each time, 3 times a week, 4 weeks were required totally, and the follow-up surveys were made 4 and 8 weeks after treatment. The scores of Western Ontario and McMaster University osteoarthritis index (WOMAC) and visual analogue scale (VAS) were observed before treatment, after 2 and 4 weeks of treatment, 4 and 8 weeks after treatment. The therapeutic effects were evaluated according to the criterion of patient global assessment (PGA) after 4 weeks of treatment and 8 weeks after treatment.@*RESULTS@#Compared with before treatment, the pain scores, stiffness scores, physical function scores and total scores of WOMAC were reduced after 2, 4 weeks of treatment and 4 weeks after treatment in the three groups (<0.05). The pain scores, stiffness scores, physical function scores and total scores of WOMAC were reduced 8 weeks after treatment in the traditional moxibustion group and the moxibustion heat group (<0.05). The stiffness score, physical function score and total score of WOMAC were reduced 8 weeks after treatment in the moxibustion light group (<0.05). The pain score, physical function score and total score of WOMAC in the traditional moxibustion group after 4 weeks of treatment were lower than the moxibustion light group (<0.05). Compared with before treatment, the VAS scores were reduced after 2, 4 weeks of treatment and 4 , 8 weeks after treatment in the three groups (<0.05). The improvement rates in the traditional moxibustion group and the moxibustion heat group after 4 weeks of treatment and 8 weeks after treatment were superior to the moxibustion light group (<0.05).@*CONCLUSION@#The light and heat of moxibustion have therapeutic effect for KOA, and the therapeutic effect of moxibustion heat is superior to moxibustion light.

The establishment of a chyle testing method based on n-hexane extraction system / 中华检验医学杂志

Objective@#To set up a chyle (n-hexane) testing method based on n-hexane extraction system.@*Methods@#The hydrothorax specimen which was positive in chyle testing was selected and the feasibility was evaluated by replace Diethyl ether with n-hexane. The optimal extraction volume ratio for the new chyle testing was confirmed and sultan Ⅲ dye process was improved. Then, the new chyle testing method and its standard operation process was established.A total of 120 specimens with triglyceride(TG)in different levels were collected and divided into three groups with 40 specimens for each group (group A. TG≤1.7 mmol/L; B. 5.6<TG<12.8 mmol/L; C. TG≥12.8 mmol/L). Then, 50 body fluid specimens were collected and used to confirm the above test results. A total of 134 real body fluid specimens were used to assessment the clinical using by review and calculating the clinical coincidence rate.@*Results@#N-hexane can replace Diethyl ether in the Chyle test. The extraction volume ratio of 1 ml sample plus 400 μl N-hexane is the best one and the sultan Ⅲ tube dying method is better than former direct smear. Compared with the old Chyle test using Diethyl ether, the new Chyle test using N-hexane is in good consistency with the Kappa value 0.95. The clinical coincidence rate of the above Chyle test reaches 94.8%(127/134) after the verification of 134 specimens.@*Conclusions@#A new N-hexane test is established successfully. It was convenient to operate with high security and little contamination and thus has a wide clinical application value.(Chin J Lab Med, 2018, 41: 527-530)

Situation analysis on nutrients intake in residents' dietary in Changning District of Shanghai in 2012 / 上海预防医学

Objective To ascertain the energy and main nutrients intake among residents in Changning District of Shanghai.Methods A stratified multistage random survey was conducted among 72 families to collect their ADI (acceptable daily intake) of nutrients through 3 d 24 h dietary recall and family condimentweigh surveys in comparison with recommended ADI.Results A total of 148 persons were included,of whom males were 75 and females 73.Every standard person daily vitamin B1,B2,A and calcium intake was relatively low.Calcium intake for 85.81% of persons was was lower than EAR.Vitamin A intake for 62.84% of persons was lower than EAR.Vitamin B1 intake for 77.7% of persons was lower than EAR.Vitamin B2 intake for 73.65% of persons was lower than EAR.In various age groups,except for women aged 18-49,contribution rate of fat in total energy exceeded recommended ADI.Conclusion Energy and main nutrients intake basically meet the needs of residents in Changning district of Shanghai.But some nutrients were still deficient severely.The source of energy nutrients was not well-balanced.More intake is recommended of milk and dairy product,soybean and bean product,vegetables and fruit.

Clinical Observation of Sofren Injection Combined with Vinpocetine Injection in the Treatment of Acute Massive Cerebral Infarction / 中国药房

OBJECTIVE:To investigate clinical efficacy of Sofren injection combined with Vinpocetine injection in the treatment of acute massive cerebral infarction,and its effects on hemorheological indexes and serum NOS.METHODS:A total of 60 patients with acute massive cerebral infarction in our hospital during Jan.2014-Jun.2016 were selected as research objects and divided into trial group and control group according to random number table,with 30 cases in each group.Control group was given Citicoline injection 0.5 g,ivgtt,qd.Trial group was additionally given Vinpocetine injection 20 mg added into 0.9％ Sodium chloride injection 250 mL,ivgtt,qd;1 h later washing tube,they were given Sofren injection 10 mL added into 0.9％ Sodium chloride injection 250 mL,ivgtt,for consecutive 14 d.Clinical efficacies and safety of 2 groups were observed,and hemorheological indexes and NOS levels were observed before and after treatment.RESULTS:The total response rate (83.33％)of trial group was significantly higher than that (50.00％) of control group,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in hemorheological indexes or serum NOS levels between 2 groups (P＞0.05).After treatment,hemorheological indexes of 2 groups were decreased significantly,and the trial group was significantly lower than the control group.The level of serum NOS in 2 groups were increased significantly,and the trial group was significantly higher than the control group,with statistical significance (P＜0.05).No obvious ADR was found in 2 groups.CONCLUSIONS:Sofren injection combined with Vinpocetine injection show significant therapeutic efficacy for acute massive cerebral infarction,can reduce blood viscosity and increase blood perfusion with good safety.

Neisseria gonorrhoeae and Chlamydia trachomatis infection in MSM with anorectal condyloma acuminatum / 中国感染控制杂志

Objective To investigate anorectal infection with Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) among men who have sex with men (MSM) with anorectal condyloma acuminatum(CA),and provide evidence for the clinical diagnosis and treatment of anorectal CA.Methods Anorectal swabs were obtained from MSM who were diagnosed with anorectal CA(trial group) and without CA(control group),nucleic acid fragments of NG and CT were detected by fluorescent quantitative polymerase chain reaction.Data about social demographic characteristics and sexual behaviors of investigated people were collected,compared and analyzed.Results A total of 158 patients were enrolled in this study,63 were in trial group and 95 in control group.Among 63 patients in trial group,infection rate of NG and CT were 17.46％ and 28.57％ respectively,co infection rate of NG and CT was 12.70％;in control group,infection rate of NG and CT were 6.32 ％ and 9.47 ％ respectively,co-infection rate of NG and CT was 2.16％;infection rate of NG and CT,as well as co-infection rate of NG and CT in trial group were all significantly higher than control group(all P＜0.05).Conclusion Infection rate of NG and CT is high in MSM with anorectal CA,suggesting that more attention should be paid to the screening of NG,CT and other sexually transmitted infection among those who were clinically diagnosed with anorectal CA.

Pharmaceutical Care on Anti-infection Therapy of Patients with Augmented Renal Clearance / 医药导报

Objective To investigate the role of clinical pharmacist in anti-infection therapy for patients with augmented renal clearance (ARC).Methods A case with multi-site severe infection after traffic accident was treated with anti-infection therapy.According to the characteristics of infection and pharmacokinetics,clinical pharmacist discussed the intervention by clinical pharmacist in terms of formulating anti-infection program and adjustment of individual dose.Results After consultation and evaluation by clinical pharmacist,the patient was diagnosed as ARC.According to pharmacokinetics characteristics reported by literature,vancomycin was adjusted to 1 g (once per 8 h).Based on detection result of pathogenic bacteria,meropenem was replaced by cefoperazone/sulbactam,and the dose was increased to 3 g (once per 6 h).And then,vancomycin concentration was detected again,and it reached ＞ 10 μg· mL-1;pathogenic bacteria culture result was negative.This patient obtained good therapeutic effect.Conclusion Clinical pharmacist could assist physician on anti-infection treatment and dose adjustment of ARC patient,and improve ARC patient's therapeutic effect.

Determinants of Calcium Infusion Rate During Continuous Veno-venous Hemofiltration with Regional Citrate Anticoagulation in Critically Ill Patients with Acute Kidney Injury / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It is unclear that how to decide the calcium infusion rate during continuous veno-venous hemofiltration (CVVH) with regional citrate anticoagulation (RCA). This study aimed to assess the determinants of calcium infusion rate during CVVH with RCA in critically ill patients with acute kidney injury (AKI).</p><p><b>METHODS</b>A total of 18 patients with AKI requiring CVVH were prospectively analyzed. Postdilution CVVH was performed with a fixed blood flow rate of 150 ml/min and a replacement fluid flow rate of 2000 ml/h for each new circuit. The infusion of 4% trisodium citrate was started at a rate of 29.9 mmol/h prefilter and adjusted according to postfilter ionized calcium. The infusion of 10% calcium gluconate was initiated at a rate of 5.5 mmol/h and adjusted according to systemic ionized calcium. The infusion rate of trisodium citrate and calcium gluconate as well as ultrafiltrate flow rate were recorded at 1, 2, 4, 6, 12, and 24 h after starting CVVH, respectively. The calcium loss rate by CVVH was also calculated.</p><p><b>RESULTS</b>Fifty-seven sessions of CVVH were performed in 18 AKI patients. The citrate infusion rate, calcium loss rate by CVVH, and calcium infusion rate were 31.30 (interquartile range: 2.70), 4.60 ± 0.48, and 5.50 ± 0.35 mmol/h, respectively. The calcium infusion rate was significantly higher than that of calcium loss rate by CVVH (P < 0.01). The correlation coefficient between the calcium and citrate infusion rates, and calcium infusion and calcium loss rates by CVVH was -0.031 (P > 0.05) and 0.932 (P < 0.01), respectively. In addition, calcium infusion rate (mmol/h) = 1.77 + 0.8 × (calcium loss rate by CVVH, mmol/h).</p><p><b>CONCLUSIONS</b>The calcium infusion rate correlates significantly with the calcium loss rate by CVVH but not with the citrate infusion rate in a fixed blood flow rate during CVVH with RCA.</p>

Interlock plate fixation for the treatment of femoral hypertrophic nonunions after intramedullary nailing fixation / 中国骨伤

<p><b>OBJECTIVE</b>To investigate clinical effect of locking plate assisted intramedullary nail in treating femoral hypertrophic nonunions after intramedullary fixation.</p><p><b>METHODS</b>From January 2006 to December 2015, clinical data of 40 patients with femoral nonunions after intramedullary nail internal fixation treated with interlock plate internal fixation were respectively analyzed. Among patients, there were 22 males and 18 females, aged from 21 to 60 years old with an average age of (35.0±2.2) years. The time of bone nonunion ranged from 9 to 24 months with an average of (14.1±1.5) months. Operative time, blood loss, hospital stay , complications, bone healing time and recovery of function were observed, Evanich scoring was applied to evaluate clinical effects.</p><p><b>RESULTS</b>All patients were followed up from 12 to 24 months with an average of (15.2±2.7) months. Operative time ranged from 105.1 to 130.2 min with an average of (112.5±10.2) min;blood loss ranged from 207.0 to 250.2 ml with an average of (220.6±14.7)ml; hospital stay ranged from 10 to 15 days with an average of (12.2±1.5) d. All patients were obtained bone healing from 4 to 12 months after additional plate internal fixation, with an average of (6.2±1.9) months. No implant failure and infection occurred after operation. According to Evanich scoring of knee joint, total score was 83.2±5.6, 22 cases obtained excellent results, 17 good and 1 fair.</p><p><b>CONCLUSIONS</b>Limited incision approach locking plate with original intramedullary nail fixation for femoral hypertrophic nonunions subsequent to intramedullary fixation could receive good results, increase stability of fracture, and could increase stability of fracture, provide environment for callus growth. It had advantages of high cure rate, less trauma and complications, and also could do functional exercise earlier to promote good recovery of knee joint.</p>

Efficacy of a newly designed modular flexible ureteroscope with holmium laser lithotripsy in the treatment of renal calculi / 实用医学杂志

Objective To evaluate the effectiveness of a newly designed modular flexible ureteroscope with holmium laser lithotripsy for the treatment of renal calculi based. Methods 40 patients were treated with modular flexible ureteroscopic lithotripsy (German Polydiagnost) with holmium laser. 40 patients were treated by traditional flexible ureteroscopic lithotripsy. Their therapeutic effects were compared. Results For modular flexible ureteroscopic lithotripsy group, 37 patients underwent successful operation, with lithotripsy with operation time of (86.0 ± 34.4) min and postoperative hospital stay of (5.3 ± 1.6) days. No severe complication including ureteral perforation, high fever or severe bleeding occurred. One month after the operation, KUB and B-ultrasonography showed complete stone free in 35 patients. Residual calculi (0. 4 cm in diameter) in the calyces were found in 2 patients. Medication and postural drainage therapy were applied. Two weeks later , KUB and B-ultrasonography showed that the residual stones have been removed completely. There was no significant differences in stone size , operation time, rate of calculus clearance, the incidence of postoperative complications, operating time and duration of postoperative hospitalization between the traditional flexible ureteroscopic lithotripsy group and modular ureteroscopic lithotripsy group. Conclusions The modular flexible ureteroscope is effective and safe in treating reanl calculi. It has similar surgical efficacy as traditional flexible ureteroscope , but is more costly effective in terms of maintenance costs.

Molecular mechanism of Golgi protein 73 in inflammation / 军事医学

Objective To study the effect of Golgi protein 73(GP73) on inflammation, and to reveal the effect of GP73 on tumorigenesis and metastasis.Methods The transcriptional activity of NF-κB and the expression of IL-1β, IL-6 and TNF-αwith GP73 overexpression or knockdown were detected to illuminate the role of GP73 in inflammation.According to the TCGA database, the correlation between the transcriptional activity of GP73 and the expression of NF-κB, IL-1β, IL-6 and TNF-αwas analyzed to determine the role of GP73 in tumor inflammation.Results Correlative analysis showed that there was a positive correlation between the expression of GP73 with NF-κB, IL-1β, IL-6 and TNF-α.The transcriptional activity of NF-κB was upregulated by GP73 overexpression, but downregulated by GP73 knockdown.The expression of IL-1β, IL-6 and TNF-αwas upregulated by GP73 overexpression.Ammonium pyrrolidinedithiocarbamate ( PDTC ) was in-volved in inflammation reaction induced by GP73.Conclusion GP73 is possibly involved in inflammation and promotes tu-morigenesis and metastasis.